The Value of Gastric Ultrasound Assessment in Airway Risk Prediction for Full-Stomach GI Surgery Anesthesia

DOI: https://doi.org/10.62517/jmhs.202605124

Author(s)

Yongjun Han

Affiliation(s)

Pengshui Autonomous County People's Hospital, Chongqing, China

Abstract

To explore the clinical value of combined qualitative and quantitative gastric ultrasound assessment in risk prediction of airway management in full-stomach patients aged 18-80 years undergoing general anesthesia in gastrointestinal surgery, and to clarify its advantages over the conventional awake intubation strategy in regurgitation and aspiration-related indicators and risk prediction, so as to provide practical evidence for the prevention and control of perioperative airway safety in gastrointestinal surgery. A total of 100 patients undergoing full-stomach surgery under general anesthesia in a tertiary hospital from January 2025 to January 2026, aged 18-80 years, were enrolled. They were divided into group A (n=50, conventional awake intubation without ultrasound assessment) and group B (n=50, individualized airway management after combined qualitative and quantitative gastric ultrasound assessment) according to the airway management evaluation and intervention methods. The risk prediction efficiency, positive rate of sputum pepsin, pharyngeal pH value, abnormal chest radiograph rate and incidence of adverse events during induction were compared between the two groups. The sensitivity (94.0%), specificity (90.0%) and AUC value (0.92) of group B in predicting high aspiration risk were significantly better than those of group A (66.0%, 70.0%, 0.68, P<0.001); the positive rate of sputum pepsin (2.0%) and abnormal chest radiograph rate (2.0%) in group B were significantly lower than those in group A (20.0%, 22.0%), and the pharyngeal pH value was closer to the physiological normal level, with statistically significant differences between the two groups (P<0.05); the incidence of adverse events during induction in group B (4.0%) was significantly lower than that in group A (18.0%) (P<0.05). The application of combined qualitative and quantitative gastric ultrasound assessment in full-stomach patients aged 18-80 years undergoing general anesthesia in gastrointestinal surgery can achieve accurate prediction of airway management risks, significantly optimize regurgitation and aspiration-related judgment indicators such as sputum pepsin, pharyngeal pH and chest radiograph, and reduce the incidence of adverse events during induction. It has more clinical advantages than the conventional awake intubation strategy and is worthy of routine promotion in gastrointestinal surgery anesthesia.

Keywords

Gastric Ultrasound; Gastrointestinal Surgery; Full-Stomach Patients; Airway Management; Risk Prediction; Sputum Pepsin; Pharyngeal pH

References

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